• Tuberculosis and Respiratory Diseases
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• 제46권1호
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• pp.122-128
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• 1999

저자들은 타질환으로 입원중 기관지내시경검사상 우연히 발견된 과립세포종 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권5호
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• pp.383-389
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• 2002

This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

• Journal of Chest Surgery
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• 제27권2호
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• pp.140-147
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• 1994

Reconstruction of the pharynx and cervical esophagus presents a tremendous challenges to surgeons. Over the past 2 years[1990, Dec.-1993, Jun], the free jejunal graft has been performed in 17 cases in Korea Cancer Center Hospital.The indications of this procedures were almost malignant neoplasms involving neck and upper aero-digestive tract; Hypopharyngeal cancer[12 cases, including 2 recurrent cases], laryngeal cancer[2 cases], thyroid cancer[2 cases, including 1 recurrent case], cervical esophageal cancer[1 case]. There were fifteen men and two women, and the mean age was 59.6 years. The anastomosis site of jejunal artery were common carotid artery[16 cases] or external carotid artery[1 case] and that of jejunal vein were internal jegular [15 cases] or facial[1 case] and superior thyroid vein[1 case]. The length of jejunal graft was from 9 cm to 17 cm[mean 13 cm] and the mean ischemic time was 68 minutes. There was one hospital mortality which was irrelevant to procedures[variceal bleeding] and one graft failure[1/16]. Other postoperative complications were neck bleeding or hematoma[3 cases], abdominal wound infection or disruption[5 cases], anastomosis site leakage[1 case], pneumonia[2 cases], graft vein thrombosis[1 case], and food aspiration[1 case]. The function of conduit was excellent and ingestion of food was possible in nearly all cases. Postoperative adjuvant radiation therapy was also applicable without problem in 7 cases. During follow-up periods, the anastomosis site stenosis developed in four patients, and the tracheal stoma was narrowed in one case but easily overcome with dilation. In conclusion, we think that the free jejunal graft is one of the excellent reconstruction methods of upper digestive tract, especially after radical resection of malignant neoplasm in neck with a high success rate and low mortality and morbidity rate.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제9권1호
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• pp.103-107
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• 2006

Belsey Mark IV 위바닥주름술은 이전의 역류 방지 수술이 실패하여 재수술을 해야 하는 경우 혹은 식도 열공 탈장이 오래 되어 유착이 있는 경우에 적응증이 된다. 본 증례는 식도 열공 탈장과 GERD로 진단되어 Nissen 위바닥 주름술을 시행하였으나 실패하였고 재수술을 시도하였지만 수술 부위의 유착이 심하여 수술적 접근이 불가능하였다. 저자들은 흉강을 통하여 Belsey Mark IV 위바닥주름술을 실시하였고, 수술 후 증상과 영양상태의 호전을 보인 1예를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.89-93
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• 2014

Background: This study was conducted to investigate the epidemiological features, clinical courses, and diagnoses of neonates who are transferred to neonatal intensive care unit of Yeungnam University Hospital due to tachypnea soon after birth. Methods: Based on medical records, we performed a retrospective study of neonatal intensive care unit admissions due to tachypnea from January 2010 to December 2013. Results: A total of 311 neonates were included in this study. The patient characteristics showed male predominance at 2.65:1. Among the 311 neonates with tachypnea, 127 (40.8%) neonates needed oxygen supply, and 54 (17.4%) neonates needed assisted mechanical ventilation. Transient tachypnea of the newborns (TTN) (158, 50.8%) showed the highest incidence, followed by pneumonia (63, 20.3%), extrapulmonary infection (37, 11.9%), respiratory distress syndrome (21, 6.8%), air leak (16, 5.1%), meconium aspiration syndrome (12, 3.9%), congenital heart disease (5, 1.6%), metabolic acidosis (3, 1%), primary pulmonary hypertension of newborns (2, 0.6%) and anemia (2, 0.6%). Conclusion: Although the neonates with tachypnea showed no other respiratory distress symptom, clinicians should be aware of the possibility of other pulmonary diseases as well as TTN and their extra-pulmonary causes. If tachypnea does not improve within a few hours, the clinician should consider further evaluation and management as soon as possible.

• Journal of Veterinary Science
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• 제24권4호
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• pp.50.1-50.6
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• 2023

This paper reports the clinical findings and surgical treatment of feline right patent ductus arteriosus (RPDA) with a left aortic arch. A two-month-old female Maine Coon was referred for an investigation of regurgitation after weaning. RPDA with a left aortic arch was diagnosed based on the echocardiographic and computed tomography (CT) findings. A right-fourth intercostal thoracotomy was found to be an appropriate approach to the duct. Preoperative diagnosis is crucial and diagnostic imaging, including radiography, echocardiography, and cardiac CT examination, is essential for determining if the aortic arch is right or left.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• 한국임상수의학회지
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• 제41권1호
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• pp.37-42
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• 2024

This case report discusses the successful surgical resection of cardiac hemangiosarcoma in a dog using an articulated surgical stapler. Cardiac tumors, particularly hemangiosarcomas, have a poor prognosis. Recommended treatment involves surgical removal of the primary tumor, along with chemotherapy. However, the use of staples for cardiac tumor resection has not yet been extensively documented in the veterinary literature. A 10-year-old dachshund with pericardial effusion underwent surgery to remove a right atrial mass. An articulated linear cutting stapler was used for tumor resection. The patient experienced chylothorax as a complication but recovered well. However, the patient later developed respiratory symptoms and died, most likely due to aspiration pneumonia. The surgical stapler provided stability, convenience, and a shorter surgical time during tumor resection. Surgical resection combined with chemotherapy improves the survival of dogs with cardiac hemangiosarcoma. The stability and adjustability of the stapling device make it advantageous for cardiac tumor resection. Although complications, such as chylothorax, can arise, appropriate management can lead to positive outcomes. This case report demonstrates the feasibility and safety of using an articulated surgical stapler for cardiac tumor resection in dogs. Insights from this case can guide future research and clinical practice.

• 대한영상의학회지
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• 제81권4호
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• pp.979-984
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• 2020

묘성증후군은 드문 유전자 결손 증후군으로, 환아는 후두 및 후두개의 기형과 신경학적 구조적 이상으로 인해 특징적인 높은 톤의 단조로운 울음소리를 내고 반복적인 흡인성 폐렴을 앓는다. 이전 보고된 증례들의 뇌 자기공명영상 소견을 정리한 결과 교뇌 저형성이 가장 뚜렷하였고, 소뇌 저형성이 동반되기도 하여 주로 후두개와의 이상 소견을 보였다. 천막상부 구조물의 위축도 자주 관찰되었는데 이것은 교뇌 저형성에 의한 이차적인 변화로 생각되었다. 본원에서 확진된 3개월 환아 또한 교뇌 저형성이 두드러져 이전 보고된 증례들과 거의 유사하였으나 수초화 양상에서 내섬유막 전완의 수초화 감소가 아니라 전반적인 수초화의 지연이 관찰되었다는 점에서 타 증례와 차이가 있었다. 후두, 교뇌, 소뇌는 비슷한 척삭에서 유래하므로, 묘성증후군에서 생기는 후두 및 뇌의 구조적 이상은 발생 초기의 이상임을 시사한다.

• Neonatal Medicine
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• 제18권2호
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• pp.257-264
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• 2011

목적: 신생아기에 기흉 발생과 관련된 호발 요인 및 각 원인에 따른 임상 양상을 조사하여 조기 진단 및 치료 효과 향상을 도모하기 위해 본 연구를 시행하였다. 방법: 2001년부터 2010년까지 순천향대학교 부천병원 신생아 집중치료실에서 기흉으로 진단받은 환아를 대상으로 후향적으로 조사하였다. 만삭아에서 발생한 원발성 기흉군과 이차성 기흉군으로 분류하였고, 이차성 기흉군에서 만삭아군과 미숙아군으로 분류하여 비교 분석하였다. 결과: 총 입원 환자 4,414명 중 57명(1.3%)이 기흉으로 진단받았고 만삭아 이차성 기흉 28명(80%), 만삭아 원발성 기흉 7명(20%)이었다. 두 군간의 성별, 출생 체중, 심폐소생술의 종류, 입원기간에 의미있는 통계학적 차이는 없었다. 흉강 삽관술 시행한 환자(20명, 57%)에서 호전까지의 기간은 원발성 기흉군에서 의미있게 길었다(5.4${\pm}$2.9일 vs. 2.7${\pm}$2.0일). 만삭아 이차성 기흉군에서 신생아 호흡곤란 증후군 선행 환자에서 폐표면활성제 투여 후 22.8시간에 기흉이 발생하였고, 태변 흡입 증후군, 폐렴, 신생아 일과성 빈호흡 환자에서는 16.6시간 후에 기흉이 발생하였다. 이차성 기흉군에서 신생아 호흡곤란 증후군(19명, 38%), 태변 흡입 증후군(11명, 22%), 신생아 일과성 빈호흡(7명, 14%), 폐렴(6명, 12%)이 선행되었다. 이차성 기흉군의 만삭아군에서 환자의 42.9%가 100% 산소 치료만으로 호전되었다. 미숙아군에서는 환자의 72.6%에서 흉강삽관술 및 27.3%에서 인공 기계 환기 치료를 필요로 했다. 결론: 신생아 시기에 폐질환이 존재시 기흉이 호발하였다. 따라서 기흉 속발 여부를 주의 깊게 관찰하고 증상에 맞는 적절한치료가 필요할 것으로 사료된다.